مقایسه اثربخشی روش‌های رفتار درمانی دیالکتیک، دارو درمانی و ترکیبی از آن‌ها بر ناگویی هیجانی و دشواری تنظیم هیجان در زنان مبتلا به افسردگی پس از زایمان

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد روان‌شناسی بالینی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه فردوسی مشهد، مشهد، ایران.

2 کارشناسی‌ارشد روان‌شناسی بالینی، گروه روان‌شناسی، واحد تربت‌جام، دانشگاه آزاد اسلامی، تربت‌جام، ایران.

چکیده

مقدمه: هدف از پژوهش حاضر مقایسه اثربخشی روش‌های رفتار درمانی دیالکتیکی، دارو درمانی و ترکیبی از آن‌ها بر ناگویی هیجانی و دشواری تنظیم هیجان در زنان مبتلا به افسردگی پس از زایمان بود.
روش کار: این مطالعه نیمه‌تجربی با طرح پیش‌آزمون و پس‌آزمون بود. جامعه پژوهش، زنان مبتلا به افسردگی پس از زایمان مراجعه‌کننده به مراکز بهداشتی و درمانی منطقه یک شهر مشهد در فصل‌های بهار و تابستان سال 1397 بودند. نمونه پژوهش 45 نفر بودند که با روش نمونه‌گیری در دسترس انتخاب و با روش تصادفی در سه گروه (هر گروه 15 نفر) جایگزین شدند. گروه اول 8 جلسه 90 دقیقه‌ای رفتار درمانی دیالکتیکی، گروه دوم روزانه 200 میلی‌گرم فلوواکسامین و گروه سوم ترکیبی از هر دو روش دریافت کردند. ابزارهای پژوهش شامل پرسشنامه‌های ناگویی هیجانی تورنتو (بگبی و همکاران، 1994) و دشواری تنظیم هیجان (گراتز و رومر، 2004) بودند. داده‌ها با روش تحلیل کوواریانس چندمتغیری و آزمون تعقیبی بنفرونی تحلیل شدند.
نتایج: یافته‌ها نشان داد که روش‌های رفتار درمانی دیالکتیکی و ترکیبی در مقایسه با روش دارودرمانی به طور معناداری باعث کاهش ناگویی هیجانی و دشواری تنظیم هیجان در زنان مبتلا به افسردگی پس از زایمان شدند، اما بین روش‌های رفتار درمانی دیالکتیکی و ترکیبی در کاهش ناگویی هیجانی و دشواری تنظیم هیجان تفاوت معناداری وجود نداشت (05/0>p).
نتیجه­گیری: براساس نتایج برای کاهش ناگویی هیجانی و دشواری تنظیم هیجان زنان مبتلا به افسردگی پس از زایمان از روش رفتار درمانی دیالکتیکی استفاده شود.

کلیدواژه‌ها

عنوان مقاله [English]

Comparison the Effectiveness of Dialectical Behavior Therapy, Drug Therapy and Their Combination Methods on alexithymia and emotion regulation difficulty in Women with Postpartum Depression

نویسندگان [English]

  • Milad Shirkhani 1
  • Negar Miri 2
1 M. A. Student of Clinical Psychology, Faculty of Educational Science and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.
2 Master of Clinical Psychology, Department of Psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran.
چکیده [English]

Background: The aim of research was comparison the effectiveness of dialectical behavior therapy, drug therapy and their combination methods on alexithymia and emotion regulation difficulty in women with postpartum depression.
Materials and Methods: This study was a semi-experimental with a pre-test and post-test design. Research population was women with postpartum depression that referring to health and care centers of Mashhad city in 2018 year. 45 people selected by available sampling method and simple random method with lottery assigned to three groups of 15 people. The first group received 8 sessions of 90 minutes of dialectical behavior therapy, the second group received 200 mg Fluoxamine per day and the third group received a combination of both methods. The research instruments were the questionnaires of Toronto alexithymia (Bagby & et al, 1994) and difficulty in emotion regulation (Gratz & Roemer, 2004). Data were analyzed by multivariate analysis of covariance and Bonferroni post hoc test methods.
Results: The findings showed that dialectical behavior therapy and combined methods in compared with the drug therapy significantly led to reduce the alexithymia and emotion regulation difficulty in women with postpartum depression, but there was no significant difference between the dialectical behavior therapy and combined methods in reducing their alexithymia and emotion regulation difficulty (p<0/05).
Conclusion: Therefore, it is suggested to reduce the alexithymia and emotion regulation difficulty of women with postpartum depression used from dialectical behavior therapy method.

کلیدواژه‌ها [English]

  • dialectical behavior therapy
  • drug therapy
  • alexithymia
  • emotion regulation difficulty
  • postpartum depression

مراجع

  1. Hutchens BF, Kearney J. Risk factors for postpartum depression: an umbrella review. Journal of midwifery &
    women's health. 2020;65(1):96-108.
  2. 2. Sharma V, Doobay M, Baczynski C. Bipolar postpartum depression: An update and recommendations. Journal of
    affective disorders. 2017;219:105-11.
    3. Freitas CJ, Williams-Reade J, Distelberg B, Fox CA, Lister Z. Paternal depression during pregnancy and postpartum:
    An international Delphi study. Journal of affective disorders. 2016;202:128-36.
    4. Mahdavy M, Kheirabadi G. The Prevalence of Postpartum Depression and Its Related Factors among Women in
    Natanz City in 2018 (Iran). Qom University of Medical Sciences Journal. 2020;14(2):78-85 [Persian].
    5. O'hara MW, McCabe JE. Postpartum depression: current status and future directions. Annual review of clinical
    psychology. 2013;9:379-407.
    6. Roberts TA, Hansen S. Association of Hormonal Contraception with depression in the postpartum period.
    Contraception. 2017;96(6):446-52.
    7. Hawes K, McGowan E, O'Donnell M, Tucker R ,Vohr B. Social emotional factors increase risk of postpartum
    depression in mothers of preterm infants. The Journal of Pediatrics. 2016;179:61-7.
    8. Narimani M, Jani S, Rezaei R. The role of alexithymia and mindfulness in predicting depression and anxiety in
    women with cancer. Shenakht journal of psychology & psychiatry. 2020;7(1):78-89 [Persian].
    9. Karukivi M, Tolvanen M, Karlsson H, Karlsson L. Alexithymia and postpartum anxiety and depression symptoms: a
    follow-up study in a pregnancy cohort. Journal of Psychosomatic Obstetrics & Gynecology. 2015;36(4):142-7.
    10. Serafini G, Gonda X, Canepa G, Pompili M, Rihmer Z, Amore M, et al. Extreme sensory processing patterns show
    a complex association with depression, and impulsivity, alexithymia, and hopelessness. Journal of affective disorders.
    2017;210:249-57.
    11. Loas G, Baelde O, Verrier A. Relationship between alexithymia and dependent personality disorder: a dimensional
    analysis. Psychiatry research. 2015;225(3):484-8.
    12. Pourkhaleghi N, Askarizadeh G ,Fazilat-Pour M. The role of maternal emotional cognitive strategies and newborn gender satisfaction in the postpartum depression in the primiparous women. Preventive Care in Nursing & Midwifery
    Journal. 2017;7(2):15-24.
    13. Grezellschak S, Lincoln TM, Westermann S. Cognitive emotion regulation in patients with schizophrenia: Evidence for effective reappraisal and distraction. Psychiatry research. 2015;229(1-2):434-9.
    14. Yousefi R, Asghari H, Toghyani E. Comparison of early maladaptive schemas and cognitive emotion regulation in
    cardiac patients and normal individuals. J Adv Med Biomed Res. 2016;24(107):130-43.
    15. Mikulincer M, Shaver PR. Attachment orientations and emotion regulation. Current Opinion in Psychology.
    2019;25:6-10.
    16. Berman NC, Shaw AM ,Curley EE, Wilhelm S. Emotion regulation and obsessive-compulsive phenomena in youth. Journal of obsessive-compulsive and related disorders. 2018;19:44-9.
    17. Fitelson E, Kim S, Baker AS, Leight K. Treatment of postpartum depression: clinical, psychological and
    pharmacological options. International journal of women's health. 2011;3:1-14.
    18. Fu S, Li F, Bie L. Drug therapy for chronic subdural hematoma: Bench to bedside. Journal of Clinical
    Neuroscience. 2018;56:16-20.
    19. Ben-Porath DD, Federici A, Wisniewski L, Warren M. Dialectical behavior therapy: Does it bring about
    improvements in affect regulation in individuals with eating disorders? Journal of Contemporary Psychotherapy.
    2014;44(4):245-51.
    20. Barnicot K, Gonzalez R, McCabe R, Priebe S. Skills use and common treatment processes in dialectical behaviour
    therapy for borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry. 2016;52:147-56.
    21. Lang CM, Edwards AJ, Mittler MA, Bonavitacola L. Dialectical behavior therapy with prolonged exposure for
    adolescents: Rationale and review of the research. Cognitive and Behavioral Practice. 2018;25(3):416-26.
    22. Zalewski M, Lewis JK, Martin CG. Identifying novel applications of dialectical behavior therapy: considering
    emotion regulation and parenting. Current opinion in psychology. 2018;21:122-6.
    23. Robinson S, Lang JE, Hernandez AM, Holz T, Cameron M, Brannon B. Outcomes of dialectical behavior therapy
    administered by an interdisciplinary team. Archives of psychiatric nursing. 2018;32(4):512-6.
    24. Fassbinder E, Schweiger U, Martius D, Brand-de Wilde O, Arntz A. Emotion regulation in schema therapy and
    dialectical behavior therapy. Frontiers in psychology. 2016;7(13):1-19.
    25. Goodman M, Carpenter D, Tang CY, Goldstein KE, Avedon J, Fernandez N, et al. Dialectical behavior therapy
    alters emotion regulation and amygdala activity in patients with borderline personality disorder. Journal of psychiatric
    research. 2014;57:108-16.
    26. Baigan K, Khoshkonesh A, Habibi Askarabad M, Fallahzade H. Effectiveness of dialectical behavioral group
    therapy in alexithymia, stress, and diabetes symptoms among type 2 diabetes patients. Journal of Diabetes Nursing.
    2016;4(3):8-18 [Persian].
    27. Ko JK. Comparing the effects of drug therapy ,physical therapy, and exercise on pain, disability, and depression in patients with chronic low back pain. Journal of Korean Academy of Nursing. 2007;37(5):645-54.
  3. 28. Miri N, Nayyeri M. Comparison the Effectiveness of Dialectical Behavior Therapy, Drug Therapy and Their
    Combination Methods on Depression and Irrational Beliefs in Women with Postpartum Depression. Iranian Journal of
    Psychiatric Nursing. 2019;7(2):1-9 [Persian].
    29. Koch MW, Glazenborg A, Uyttenboogaart M, Mostert J, De Keyser J. Pharmacologic treatment of depression in
    multiple sclerosis. Cochrane database of systematic reviews. 2011(2):1-37.
    30. Huang J-w, Zhou X-Y, Lu S-J, Xu Y, Hu J-B, Huang M-l, et al. Dialectical behavior therapy-based psychological
    intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report. Journal of
    Zhejiang University-SCIENCE B. 2020;21(5):394-9.
    31. Akhavan S, Sajjadian I. Effectiveness of dialectical behavior therapy on emotional instability and impulsivity in
    bipolar patients. Journal of Clinical Psychology. 2016;8(3):11-23 [Persian].
    32. Naddaf shargh H, Gholi pour M, Toopkanlooi S. The Effectiveness of Existential Group Psychotherapy on
    Postpartum Depression in Nulliparous Women. journal of ilam university of medical sciences. 2016; 23(6): 185-195
    [Persian].
    33. Aydın A. A comparison of the alexithymia, self-compassion and humour characteristics of the parents with mentally
    disabled and autistic children. Procedia-Social and Behavioral Sciences. 2015;174:720-9.
    34. Besharat MA. Reliability and factorial validity of a Farsi version of the 20-item Toronto Alexithymia Scale with a
    sample of Iranian students. Psychological reports. 2007;101(1):209-20 [Persian].
    35. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and
    behavioral assessment. 2004;26(1):41-54.
    36. Besharat MA, Bazzazian S. Psychometri properties of the Cognitive Emotion Regulation Questionnaire in a sample of Iranian population. Advances in Nursing & Midwifery. 2014;24(84):61-70 [Persian].
    37. Linehan M. Dialectical behavior therapy frequently asked questions. USA (Seattle): Behavioral Tech, LLC. 2008.
    38. Najarpour S, Khalatbari J. The effectiveness of group cognitive therapy and dialectical behavior therapy on
    students’ general health. Thoughts and Behavior in Clinical Psychology. 2016;10(38):17-26 [Persian].
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 64، شماره 4
مهر و آبان 1400
صفحه 3427-3439

فایل ها

هم رسانی

ارجاع به این مقاله

آمار